中医对核苷(酸)类似物引发乙肝病毒耐药的多维认识

Multidimensional understanding of traditional Chinese medicine on HBV drug-resistance induced by nucleos(t) ide analogues

核苷(酸)类似物引发的乙肝病毒(HBV)耐药问题已成为一个严峻的医学难题,但限于现有认识及技术水平尚无更好的解决措施。拥有成熟理论体系的中医学能否在减少耐药率或延缓耐药发生时间等方面发挥作用,这是一个值得我国从事中医肝病研究学者们深思的课题。中医五行学说的"生克关系"是一种反映多系统关系的经典逻辑模型,但其仍存在不足。本文将首先基于五行学说中木、火、土、金、水的阴阳关系实质提出五行"阳化模型",然后从中医整体观层面构建包括"生克模型"、"阳化模型"的五行三维关系逻辑模型,继而应用取象比类思维赋予HBV、宿主、药物三者中医五行特征,最后推导出核苷(酸)类似物抗HBV耐药的中医病机及中医治则治法等。

HBV drug-resistance induced by nucleos （t） ide had become a serious medical problem, but limited to the ex-isting knowledge and technology, there was no better solution.whether traditional Chinese medicine （ TCM） could reduce the rate of drug resistance or delay drug resistance？ It is a subject worthy of thinking.TCM theory of interpromotion and interrestriction in the five elements is a classical logic model to reflect relationship of multiple systems , but it is not perfect.At first, we would based on Yin-Yang theory proposed“Yang of model” of five elements theory , then building five elements three dimensional re-lationship logic model, which including“interpromotion and interrestriction model” and“Yang of model” .Give the hepatitis B virus, the host and the drug to five elements characteristics by taking as class methods on the analogy of the appearance of the matters.Finally, derived the pathogenesis, principles of treatment, and therapeutic method of TCM on HBV drug-resistance in-duced by nucleos （ t） ide analogues.